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BP6019BUILDING PERMIT APPLICATIOrI Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 6 019 (402) 426-4191 Permit t ~ Application Date: g,-- j. c/y Issue Date: `~ p ~ "~ ~ Permit Fee: $ ~ ~ - JOB ADDRESS LEGAL 1 ' DESCR. LOT N0. BLK. TRACT ^ SEE ATTACHED SHEET 2. OWNER ~C, \ ~///~CC/ MAILADDRESS 1 ~X ~3 ~ICC //'~ ZIP ~~~~ JS ~ rP~ONE 3. CONTRACTOR ,r\~~~t,/ ~~ G ~I AIkADDRESS rC rill rC,. J /"/~~ U NE ~ j_ ~~~ ^~ EN~ 0. USE OF BUILDIN G 4. 5. Class of Work: ^ NEW ^ ADDITION ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: ~ _ '~ ~i /~ 0 ~ ~~il' `- C f[ C ~" 7. Sq. FOOtage of StrUCtUre (Including Basement and Garage): 8. Change of Use From: Change of Use To: g, Valuation of Work: $ ~" p~Cj , (') C~ 10. Floodplain: Flooawey Yes ^ No ^ Dev. Permit Fringe Yes^ No ^ BFE Elev. Cert. 11. Current Zoning: l'e L~ 12. State Fire Marshall Required: Yes ~ No^ 13. Special Use Permit Required: Yes ^ No 14. Variance Required; Yes^ No~ 15. Minimum Setbacks; Front l Side _~ Rear / 16. Sidewalk Required: Yes ^ No [~] Waiver Approved APPL~~~~ EFyT~~/ BY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY NOTICE Separat permits are required for electrical, plumbing, heating, ventilating and air condi- tioning, and septic systems. By my signature below, I achnowledge that payment of the building permit application fee does not constitute issuance of this building permit. I further agree that construction covered by this permit application shall not be commenced until I have received a copyof this application form signed bythe Building Inspector and stamped 'APPROVED'. I hereby agree to perform the proposed work in accordance with the specifications set forth above and in acco ce with the codesJordinances of the Ciry of Blair and the State of Nebraska. I un st d that this permit is void if work is not commenced within 180 days or is not com to ithin 2 years of date of issue. ~~ SIGNATUR 0 WNER~CONTRAOTOR OR AUTHORIZED AGENT DATE SIGNATURE OF OWNER (IF OWNER BUILDER) DATE Site Plan Attached Complete Plans Attached ^ Approximate Co pletion Date ~1U y l / ~ `~ ~ Inspections Required and Fees Sewer Tap ~ Utilities Water Tap '~ Sewer / Water Service Septic Remote Building Footings Drywall (before finish) A/~Z3-QS' Framing Final Electrical Rough-in Fixtures Final Permanent Service Temporary Service Mechanical Rough-in ABC Final Ground Work y Plumbing Rough-in a/ Final +~ WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Approv d 'OUNDS PRTG: BIeIr, NE Rev. 10/9 BUILDING PERMIT APPLICATION Jurisdiction of City of Blair, Nebraska 218 South 16th Street Blair, Nebraska 68008 5 4 71 (402) 426-4191 Permit Application Date: ~ ! ~ ' ~~ Issue Date: ~ ' ~ ~ ~ ~ Permit Fee: $ ~C) .C~ JOB ADDRESS ~ „ ~ ~ ~~ ~ ~ I . T G LEGAL 1 ' DESCR. LOT N0. BLK. TRACT ^ SEE ATTACHED SHEET 2. OWNER ~~c I~ I~-t ll cv MAIL ADDRESS ZIP PHONE ,3' CONTRACTOR ~~~~ MAILADDRESS PHONE LICENSE NO. 4. USE OF BUILDING 5. Class of Work: ^ NEW ^ ADDITION ^ ALTERATION ^ REPAIR ^ MOVE ^ REMOVE 6. Describe Work: ~ ~,~/~ J r-m ~ ~~ ~C ~~~ ~~ ~~E~~ cj ~-~ 7. Sq. Footage of Structure ~md~dlnyeaSamaMaRdcara9a): $. Change of Use From: Change of Use To: g, Valuation of Work: $ ~ ~ ~l(~U Floodway Yes^ No ^ 10. Floodplain: Fringe Yes^ No ^ Dev.Permil BFE EIev.Cert. 11. Current Zoning: 12. State Fire Marshall Required: Yes ^ No^ 13. Special Use Permit Required: Yes ^ No ^ 14. Variance Required: Yes ^ No ^ 15. Minimum Setbacks: Front Side Rear 16. Sidewalk Required: Yes^ No ^ Waiver Approved _ Site Plan Attached ^ Complete Plans Attached ^ Approximate Completion Date Inspections Required and Fees ~~ Utilities Sewer Tap Water Tap Sewer Water S Septic Remote I APPbICA~~~ACCEPr T~EDJBY I PLANS CHECKED BY I APPROVED FOR ISSUANCE BY I / NOTICE Separate permits are required for electrical, plumbing, heating, ventilating and air condi- tioning, and septic systems. By my signature below, I achnowledge that payment of the building permit application fee does not constitute issuance of this building permit. I further agree that construction covered by this permit application shall not be commenced until I have received a copy of this application form signed bythe Building Inspector and stamped 'APPROVED'. I hereby agree to perform the proposed work in accordance with the speafications set forth above and in accordance with the codes~ordinances of the City of Blair and the State of Nebraska. erstand that this permit is void if work is not commenced within 180 days or is not mpl fed within 2 years of date of issue. SIGNAT~IRE OF OWNERJCONTRACTOR OR AUTHORIZED AGENT DATE SIGNATURE OF OWNER (IF OWNER BUILDER) DATE = Drywall (before finish) Framing Final P Electrical j~ o~o~o~ . - /yl~. /~r/!dl(at ~ ~ / ~ WCJ~3 ~!a do o~n Rough-in /~-c.~-t.>*vt~ Fixtures Final ~ ~ - ~ ~~ ~~M Permanent Service Temporary Service e Mechanical Rough-in ~~,rr~ ABC Final ~ Ground Work Plumbing Rough-in ~ ~rn-t~n~. Finaf ~~ WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT Comment: Appr d y SOUNDS PRTG: BIaIr, NE Rev. 10181 i ;' City of Blair 218 South 16th Blair, Nebraska 68008 40~-426-4191 ~i ~ °~' a • o~ V\ ~ promise July 27, 1993 Rick Hillman 523 N. 23rd St. Blair, NE 68008 Dear Mr. Hillman, The extension you requested on your building permit for the residence located at 523 N. 23rd Street expired on July 1, 1993. Please be aware that you must now renew your building permit or contact Bill Wilson for a final inspection of your project. You may reach him at the above number between 8:00 a.m. and 10:00 a.m., Monday through Friday to arrange this inspection. Thank you for your cooperation in this matter. Sincerely, Brenda Taylor City of Blair City of Blair 218 South 16th Blair, Nebraska 68008 402-426-4191 ~^ . ~ ~ promise ~, O ~J March 11, 1993 Rick Hillman 523 N. 23rd St. Blair, NE 68008 Dear Mr. Hillman, This is to notify you that the building permit you were issued on March 8, 1991, has now expired. Please be aware that you must either obtain a renewal on this permit or discontinue any building or construction you may be doing at 523 N. 23rd Street. If you have completed this project, please contact Bill Wilson at 426-4191 for a final inspection. If you have any questions, please contact our office. Thank you for your cooperation in this matter. Sincerely, J ~OY~. Brenda Taylor City of Blair